A comparison of the lung deposition of budesonide from Easyhaler (R), Turbuhaler (R) and pMDI plus spacer in asthmatic patients

Inhaled corticosteroids in pressurized metered does inhalers (pMDIs) are of ten delivered via a large volume spacer device, but these are bulky and inc onvenient. Dry powder inhalers (DPIs) provide a highly portable and conveni ent propellant-free alternative to pMDIs for asthma maintenance therapy How ever, each DPI could have unique in vivo delivery characteristics. In order to quantify the total and regional lung deposition of budesonide (200 mug) from (a) Easyhaler(R), (b) Turbuhaler(R) and (c) pMDI plus Nebuhaler(R) 75 0 ml spacer, a three-way randomized cross-over study was carried out in 12 mild to moderate asthmatic patients. Deposition was quantified by the imagi ng technique of gamma scintigraphy. Optimal inhalation techniques were used throughout. Mean (SD) whole lung deposition (% metered dose) was similar f or Easyhaler(R) [18.5 (7.8) %] and Turbuhaler(R) [21.8 (8.2) %], but was si gnificantly higher for pMDI plus Nebuhaler(R) [44.1 (10.0) %, P < 0.01]. Th e regional distribution patterns in the lungs were predominantly central fo r all three devices. Nebuhaler(R) reduced oropharyngeal deposition signific antly compared with the two DPIs. Easyhaler(R) Showed comparable deposition to Turbuhaler(R) and hence drugs delivered by Easyhaler(R) would be expect ed to have a similar clinical effect to those delivered by Turbuhaler(R) in asthma maintenance therapy, (C) 2001 Harcourt Publishers Ltd.